Determinants of Utilization of Family Planning Essay

This study was conducted on the determinants of utilization of family planning services among women of Gambari ward in Ilorin, Kwara State.

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The specific objectives were to determine the level of utilization of family planning services, to assess the level of knowledge of family planning among women of reproductive age group in Gambari Ward, to determine the proportion of women currently using family planning methods and to determine the proportion of women who wish to use family planning services but cannot access the services.Determinants of Utilization of Family Planning Essay

The study was a descriptive cross-sectional study. A Cluster random sampling method was used. Our study populations were female residents of Gambariward within the reproductive age group. Relevant information was obtained through a 5-section structural questionnaire that assessed areas of interest with both open and closed-ended questions. Data analysis was done using SPSS version 20.0 and results were presented by means of tables, charts and graphs.

Majority of the respondents were aware of family planning services. However,the level of utilization was low due to religious beliefs, spouse refusal, cost and other misconceptions on family planning use.Determinants of Utilization of Family Planning Essay

Appropriate recommendations were made to the government and the community as a whole, on how to improve the overall utilization of family planning services.

TABLE OF CONTENTS

Title Page i

Certification ii

Dedication iii

Acknowledgements iv

Abstract v

Table of Contents vi

CHAPTER ONE

1.1 Background information 1

1.2 Problem statement 2

1.3 Justification for the Study 3

1.4 Objectives of the Research 4

1.41 General objectives

1.42 Specific Objectives

1.5 Conceptual framework 5

CHAPTER TWO

2.0 Literature Review 6

CHAPTER THREE: METHODOLOGY

3.1 Description of study area 22

3.2 Study Design 23

3.3 Study population 24

3.4 Sampling technique and method 24

3.5 Minimum sample size determination 25

3.6 Research instrument 26

3.7 Data Collection, Analysis and Presentation 26  Determinants of Utilization of Family Planning Essay

3.8 Ethical consideration 27

3.9 Method of data dissemination 27

3.10 Limitations of the study 28

CHAPTER FOUR: RESULTS

4.1 Socio-demographic characteristics 29

4.2 Gynecologic and reproductive history 35

4.3 Level of awareness of family planning 35

4.4 Level and determinants of utilization of family planning 39

4.5 Perception on family planning 40

4.6 Cross-tabulations. 43

CHAPTER FIVE

Discussion 47

CHAPTER SIX

Conclusion 50

Recommendations 51

References 53

Sample Questionnaires

CHAPTER 1

INTRODUCTION

1.1 BACKGROUND INFORMATION

Family planning, as explained by World Health Organization (WHO), allows individuals and couples anticipate and attain their desired number of children and the spacing and timing of their birth. It is achieved through the use of contraceptive methods. A woman’s ability to space and limit her pregnancies has a direct impact on her health and well being as well as outcome of each pregnancy.Determinants of Utilization of Family Planning Essay

Uptake of family planning methods remains low in Sub-Saharan Africa including Nigeria. This may be associated with high incidence of unintended pregnancies, unsafe abortions and maternal death [1, 2]. The United Nations Sustainable Development Goal (SDG) 5 aims at improving maternal health and reducing maternal mortality by three quarters between 1990 and 2015. An important intervention towards achieving this target is the promotion of family planning among women of Sub-Saharan Africa [1, 3].

Several studies have been conducted on determinants of family planning use. In some cases strong associations have been established between family planning and some socio-demographic, socio-cultural and socio-economic characteristics of women. Studies have revealed that use of family planning methods was found more in women of older age group [4, 5]. Education has also been observed in many other studies to be associated with contraceptive use [4, 6, 7].

1.2 PROBLEM STATEMENT

United Nations MDG5 aims at improving maternal health and reducing maternal mortality by 75% between 1990 and 2015. An important tool towards achieving this target is the promotion of family planning among women. Unfortunately, uptake of family planning methods remains low in Sub-Saharan Africa.Determinants of Utilization of Family Planning Essay

In a study conducted in Ghana, it was estimated that about 17% of married women use modern contraceptive method [8]. This suggests that the use of contraceptive methods, especially modern ones, still remains low among women in Ghana. In the same study, it was estimated that unmet need increased from 30% to 34% in 2008. It is therefore imperative to establish and understand the factors that serve as barrier to the use of contraceptives and available family planning services.

Family Planning services are preventive health services that provide quality, low cost and easily accessible reproductive health care to women and men during their reproductive years. Family planning is often limited to the use of contraception. However, family planning provides a holistic service that aims to promote a positive view of sexuality and enable people to make informed choices about their sexual and reproductive health and well-being. It also ensures that resources are available for raising a child in significant amount, which include time, finance and social environment at intervals mutually determined by both partners to have their desired number of children. Studies indicates that the utilisation of family planning services in Nigeria is low when compared to high population growth rate in Africa, high fertility that translates into high population growth. Many scholars reported that it is likely that the utilisation of family planning services can alter the population growth rate. Studies have also shown that contraceptive knowledge, and usage is very low in Nigeria, hence the reason for the high fertility and increase population.Determinants of Utilization of Family Planning Essay

NOW

Aim: There for the study aimed at determining factors influencing the utilisation of family planning services among female of reproductive age (15-45 years) in Bauchi Local Government Area, Bauchi State, Nigeria.

Method: A descriptive cross-sectional study was conducted. Hundred questionnaires were distributed to 100 women of reproductive age of which 96 of them were retrieved. Data was analysed using Statistical Package for Social Sciences (SPSS). Descriptive statistics was used to summarise and organise the data. Pearson’s Chi-square test was used to test for association between variables and level of significant was set at 5% (0.05).

Findings: Results from this study show that (84.4%) respondent’s utilisation of family planning services depends on husband’s acceptance of the family planning method. The study also found that cultural acceptance, access to family planning services, schedule of family planning clinic, effectiveness of family planning method and awareness; 75%, 75%, 62.5%, 79.2% and 63.5% respectively all influence utilisation of family planning. Academic attainment and knowledge of family planning methods were significant and influence family planning use.Determinants of Utilization of Family Planning Essay

Conclusion: The study showed that family planning used depends on husband’s acceptance of the family planning method. This study also recommends for spouses to be continuously involved in family planning education as their approval influences family planning. It is hoped that the knowledge of this research will help health care givers to provide adequate health education to clients and family in the community to expand their knowledge of family planning services to ensure adequate child spacing and reproductive health. Thus, preventing unintended pregnancies, reduce maternal and child morbidity and mortality rate.

Key words
family planning, utilisation, women of reproductive age

Introduction
Family planning services is an educational, comprehensive medical or social activity which enables individuals to determine freely the number and spacing of their children and to select how this may be achieved [1]. The National Survey of Family Growth (NSFG) in Chandra, et al. [2] indicated that 41.7% of women of reproductive age receive at least one family planning service from a medical care provider either already pregnant, seeking to become pregnant or infertile because of sterilization.Determinants of Utilization of Family Planning Essay

Nonetheless, the low percentage of individuals using family planning services suggests that either some women are not planning their pregnancies deliberately or they are experiencing problems accessing this type of services [3]. Family planning in Nigeria is one of the pillars of safe motherhood where women can access services that would prevent unwanted pregnancies [4]. In Nigeria, family planning services are frequently delivered in clinics with little or no connection with medical facilities. The utilisation of these services in Nigeria is low when compared to the high fertility and population growth rate in Africa, high fertility translates into high population, and the growth rate was estimated to be between 2.5 and 3.0 per cent per annum [5,6]. Osemwenkha [6] further stated that it is likely that the utilisation of family planning services can alter the population growth rate, reports have shown that contraceptive knowledge, and usage is very low in Nigeria, hence the reason for the high fertility and increased population.Determinants of Utilization of Family Planning Essay

The underutilisation of family planning methods in these regions is attributed to low literacy and low socio-economic status of women [7]; and spousal communication on family planning has also been found to influence contraception use [8]. Again, a study by Chacko [9] found that the number of living sons a woman has also influences her contraceptive use. The resultant effect of underutilisation of these services is a leading cause to the high prevalence of teenage pregnancy and maternal deaths in Africa.

According to Cleland, et al. [1] family planning services are necessary for the widespread of adoption of preconception care for planning pregnancies and counseling. The potential of family planning services is to promote preconception care which is limited by underutilisation of these services and adequate attention to preconception care during the reproductive years is dependent on the woman and man planning their pregnancies, not only in respect to their timing but also on health-related factors that would maximize their chances for a healthy pregnancy and healthy infant.Determinants of Utilization of Family Planning Essay

Child spacing, which is one of the benefit of utilising family planning services have been identified as a means of reducing maternal deaths [10]. Globally, 99% 0f maternal deaths and disability occur in the developing countries, and Nigeria alone accounts for 10 percent [11]. In addition, utilisation of family planning helps to prevent women from participating in unsafe abortion practices [4]. This is because in Nigeria, like many other African countries, abortion is illegal and the United Nation Population Fund (UNFPA) 2009 reported that 74,000 women were estimated to die because of unsafe abortion. This report further explains that 50 million induced abortions were performed each year of which 20 million are performed in unsafe conditions or by untrained providers. Thus, the use of family planning services reduces the number of unintended pregnancies, thereby promoting women reproductive health by decreasing the number of times a woman is exposed to the risk of pregnancy and child bearing in adverse conditions [12]. Family planning saves lives and can improve the health of women, children and society as a whole  Determinants of Utilization of Family Planning Essay

The National Survey of Family Growth (NSFG) (2002) reported that 41.7% of women 15 to 44 years of age received at least one family planning service from a medical care provider. This percentage is not as alarming as it might appear at first glance, because some of the women who did not seek family planning services already were pregnant, seeking to become pregnant, or infertile because of sterilization or other reasons. Nevertheless, this rather low percentage suggests that some women are not either planning their pregnancies deliberately or because they are experiencing problems, obtaining family planning services [3]. The growth rate in Nigeria is estimated to be between 2.5-3.0% increasing per annum currently estimated to 190million persons and is expected to reach 338million persons by 2050, which pose various problems for economic growth and development in the country [13].Determinants of Utilization of Family Planning Essay

Utilisation of family planning services need to be increased and the content of such services expand to achieve the reproductive health of women. Hence, it becomes expedient to conduct this research to understanding the factors influencing utilisation of family planning services is critical to the efforts of programmes targeted at meeting the demand for contraception.

Methodology
A descriptive cross-sectional design was used for this research. It was designed to determine factors influencing the use of family planning services among females of reproductive age (15-45 years) in Bauchi Local Government Area of Bauchi State, Nigeria.

The research was carried out among women of reproductive age (15 – 45 years) in Bauchi Local Government Area, Nigeria. Bauchi is a small community with a total population of 4,676,465 people and over 104,884 females [14]. Dan’lya, Birishi and Dan’amar wards were selected within Bauchi. These wards are deprived wards and have 35,879 females of childbearing age [14].Determinants of Utilization of Family Planning Essay

A sample population of 100 female of reproductive age (15-45 years) was drawn out of the target population. A convenience sample was used in selecting participants who meet the study criteria. Eligible participants were female of reproductive age (15-45 years) who were willing to participate in the study.

Data was collected using semi-structured questionnaire after an extensive literature review on family planning services.Determinants of Utilization of Family Planning Essay

The design and conduct of this study was fully approved and monitored in accordance by the Community Heads of Dan’lya, Birishi and Dan’amar wards. Informed consent from the respondents was obtained. The working practices and confidentiality requirements of all participating individuals was fully respected and the anonymity of all participants in the research was assured.Determinants of Utilization of Family Planning Essay

Data analysis
Data collected was imputed into the computer using Statistical Package for Social Science (SPSS) for data analysis and results presented using descriptive statistical tools such as percentage tables. Pearson’s Chi-square test was utilised. The level of significant was taken at 0.05. Cross-tabulation tables were used to explain the relationship between factors influencing utilisation of family planning and its associated variables

Abstract
Everyone has the right to decide on the number and timing of children without discrimination, violence and oppression, to have the necessary information and facilities for it, to access sexual and reproductive health services at the highest standard. Deficient or incorrect family planning methods, wrong attitudes and behaviors toward the methods and consequent unplanned pregnancies, increased maternal and infant mortality rates are the main health problems in most countries. Individuals’ learning modern family planning methods and having positive attitude for these methods may increase the usage of these methods and contributes the formation of healthy communities. It is considered important to examine the current attitudes and determinants in order to spread the choice of effective method.Determinants of Utilization of Family Planning Essay

Keywords
womenattitudesfamily planningreproductive health
Chapter and author infoShow +
1. Introduction Determinants of Utilization of Family Planning Essay

Everyone has the right to decide on the number and timing of children without discrimination, violence and oppression, to have the necessary information and facilities for it, to access sexual and reproductive health services at the highest standard [1]. Deficient or incorrect family planning methods, wrong attitudes and behaviors toward the methods and consequent unplanned pregnancies, increased maternal and infant mortality rates are the main health problems in most countries.

Individuals’ learning modern family planning methods and having positive attitude for these methods may increase the usage of these methods and contributes the formation of healthy communities [2]. More than 22 million unsafe abortions that occur every year cause about 47,000 maternal deaths in the short or long term, mostly in developing countries [3]. It is estimated that up to one-third of maternal deaths can be prevented by using contraception in women who are seeking to postpone or delay postpartum [4].

Across the world, it is estimated that 222 million women have unmet need for family planning [5]. This unmet need prevalent in particular populations, especially those who are sexually active, those with low socioeconomic status, those living in rural communities and those coping with conflicts and disasters [6].Determinants of Utilization of Family Planning Essay

Increasing usage of contraceptives in some developing countries has reduced the annual number of maternal deaths by 40% in the last 20 years and has reduced the maternal mortality rate (the number of maternal deaths in 100,000 live births) by 26% in recent years. If the need for uncontrolled birth is met, it is estimated that maternal mortality still occurring in these countries can be avoided by more than 30% [7]. The ‘Family Planning 2020’ initiative was started at the London Family Planning Summit in July 2012. The main objective of this initiative is to provide contraceptive information, services and supplies for 120 million women and girls until 2020 [8].

2. Family planning

Family planning is defined as having the freedom and responsibility of all the couples and the individuals to decide the number of children they desire and having the knowledge, education and tools for this purpose. In other words, family planning is a preventive service that allows married couples achieving their desired number of children and deciding the spacing of pregnancies according to their economic opportunities and personal wishes, and to ensure that the births are at appropriate intervals for the mother and child health.

Family planning does not mean limiting the number of people in a family. The goal of family planning is preventing pregnancy-related health risks in women and reducing the need for unsafe abortion and infant mortality (see Table 1). Maternal health, risk of pregnancy and even maternal death significantly increase when births made at intervals of less than 2 years. In addition, babies born at frequent intervals are not fully developed (babies with low birth weight), disability rate increases, care becomes difficult and infant mortality increases in the mother’s womb. Determinants of Utilization of Family Planning Essay

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